Six Trends to Watch in 2021


It’s a New Year – what should you keep your eyes on and where should you anticipate change?

COVID-19 dominated healthcare in 2020. The virus simultaneously crushed some radiologists with an overwhelming workload while leaving others parched for scans to interpret. But, it is now a New Year with a brand new horizon. What can you expect out of the next 12 months?

Diagnostic Imaging spoke with Mina S. Makary, M.D., an interventional radiologist with The Ohio State University Wexner Medical Center about what he saw as areas in the specialty and industry that deserve your attention. From the lingering pandemic to technological developments to radiology’s culture, he shared his insights.

Here he is, in his words:

COVID-19: This is the biggest issue radiology is dealing with right now. We’re continuing to learn more about its imaging manifestation, including the extra-pulmonary manifestations. It doesn’t only affect the lungs. There are also neurological and cardiac findings. Learning more and more about this disease – having a bigger knowledge base and further characterization of COVID – is going to help us as radiologists as we prepare for future pandemics.

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It will also affect our workflow and healthcare systems. The initial wave had a huge impact, and now we’re getting into the second wave that’s even higher than the first. It impacts radiology workflow, department readiness, workforce resilience – all kinds of factors. We will need to focus on how we will utilize our resources most effectively – where do we want to scan our patients, how many can we help in a safe fashion, and with what precautions? How will we deal with staff issues if members of our teams end up exposed and we have to work with less resources? We must determine how to optimize our departments to continue to deal with this epidemic from a clinical, personnel, and business standpoint.

Reimbursement Cuts: The American College of Radiology and other radiology associations are lobbying Congress because there are new Medicare cuts in 2021. This is coming in the middle of a pandemic when there is less volume and less revenue in healthcare systems, groups, and radiology practices. It’s just going to be another layer that will impact a great deal of everyone’s practice – especially radiologists who are in smaller practices that are trying to make it through.

Artificial intelligence: Over the last few years, the impact of artificial intelligence and machine learning has been exponential, and it’s only going to keep growing that way. More and more – every day – new applications are coming up to help us improve specific disease diagnosis.

One thing we will continue to work on, as a specialty, is how we can integrate this technology into our clinical workflow. Rather than worrying about artificial intelligence replacing radiologists, everyone is now thinking about how artificial intelligence will augment their performance to become better, quicker, and more accurate. Our goal now is to determine the best role for it. There are a lot of amazing applications coming up with opportunities for improving patient care with the new wave of technology focusing on improving a radiologist’s efficiency.

In the past, we had plain film. Then, we had a huge efficiency impact on our specialty with the introduction of PACS systems that we now use to view images. That took us from looking at individual films that you’d hang up in the dark room to being able to view studies and large number of images in an electronic way. Now, the next big jump is being able to handle thousands and thousands of images, and artificial intelligence is being leveraged to help us take our specialty through the next transformation phase in 2021 and beyond.

3D Printing: This may not necessarily be in 2021, but in the long term, 3D printing will continue to be among the next generation of technologies for radiology. And, it is huge – so much so that RSNA dedicates an entire section to just 3D printing. It’s being used for patient education, to train surgeons and other colleagues with practice surgeries, and for surgical planning. If we need to visualize a complex structure, a 3D printer can create a model we can use to observe, teach, explain the disease better to students and patients.

Interventional radiology: In addition to these growing innovations in the diagnostic core of radiology, the interventional side is also evolving new ways to implement cutting-edge therapies using imaging guidance. There are many exciting procedures that have been developed that are now gaining more and more applications. For example, geniculate artery embolization where interventional radiologists, through a small incision and vascular access via microcatheters and wires, are able to target the vessels that contribute to knee inflammation in patients with moderate-to-severe osteoarthritis. Patients can feel significantly improvement in pain and quality of life after this same-day outpatient procedure without the need for invasive surgery.

Additional innovative ways embolization is having a huge impact include for men with symptomatic enlarged prostate glands and in women who are suffering with fibroids. For example, instead of a hysterectomy, we can stop the blood flow to the fibroids and shrink them while preserving the uterus, so the patient can go home same-day with quick recovery, no scars, less risk of complications, and in a cost-effective fashion. So, there are a lot of minimally invasive therapies that are developing, and radiologists are at the center of this revolution. Not only we are effective in diagnosing patients, but we are now more than ever also using that knowledge to treat patients and provide great outcomes in minimally invasive ways.

Policy and Culture: Our country has had a larger national conversation about race, gender, and equality issues over the past few years. As a reflection of this, there is a move in organized radiology for diversity and inclusion across the board. We can see that all levels of organizations, such as the American College of Radiology and the Society of Interventional Radiology, promoting diversity and providing opportunities to all members from a variety of backgrounds. These trends are only going to continue to grow and make us stronger as a specialty. It serves to make us one big family.